The present disclosure describes systems and methods to evaluate auditory efferent function by exposing a patient to short-duration acoustic click stimuli to generate a click-evoked otoacoustic emission (CEOAE) occurring in each ear of the patient, and in response to exposing the patient to click stimuli, concurrently sampling outer hair cell activity (OHC) and medial olivocochlear reflex (MOCR； efferents) in each ear of the patient, monitoring the middle ear muscle reflex (MEMR) in each ear of the patient, and measuring a change in cochlear activity in the patient based on the CEOAE, MOCR, and MEMR of each ear of the patient.
